Hear rate Variability in minors under 18 years with cerebral palsy and its relationship with gross motor function: a systematic Review

Abstract

Introduction: Cerebral Palsy (CP) is the main cause of motor deficiency in the child and adolescent population. Its rehabilitation requires non-invasive, cost-effective and easy-to-use measurement systems. Heart rate variability (HRV) meets these requirements, but reference parameters are still lacking in children under 18 years of age with CP. The objective is to write the CRV in children under 18 years of age with CP and its relationship with gross motor skills according to the Gross Motor Function Classification System (GMCFS). Materials (or patients) and Methods: Systematic review. We searched 11 databases and references from eligible studies that included observational, experimental, and quasi-experimental designs, populations younger than 18 years with CP, and classified with GMFCS. HRV was assessed at rest using time and frequency domain analysis. Risk of bias was assessed using Robins-I. Results: 264 articles were identified. Seven met the inclusion criteria, with a total of 242 patients aged between 4 and 14 years. VRC reporting was done across time (SDNN and rMSSD) and/or frequency (HF, LF, HF, and LF/HF) domains. Conclusions: There is limited evidence on the analysis of the diffe- rent domains of the CVR in children under 18 years of age with PC. Findings are conflicting regarding the relationship between VRC and GMFCS. A larger number of studies, larger sample sizes, and better control of confounding variables are still required to generate relationships and reference parameters according to GMFCS.